00:01
With Nephritic, their primary disorder
is dealing with neutrophils.
00:05
Keep that in mind.
00:06
Because I've asked you to focus on that H.
00:08
Let's take a look at hypertension.
I understand.
00:11
Whenever there is issues of renal failure
or issues with the kidney in general,
you are going to retain that sodium.
00:18
Therefore,
contributing to that hypertension.
00:22
Now, when I say
there is massive protein loss
with Nephritic syndrome,
I understand that
even if you are going to lose protein,
but it will not be as much as three
and a half grams of protein loss per day.
00:38
Greater than 3.5
grams of protein loss per day
automatically puts you in the category
of Nephritic
and it's edema
and nephritic will be significant.
00:48
You are still going to lose protein
with Nephritic syndrome,
but not as greatly.
00:55
So therefore, here the type of edema
will be periorbital type of puffiness.
01:00
And once again,
usually your due to that salt retention
and resulting
in increase hydrostatic pressure.
01:08
Edema can be more generalized.
01:10
However, remember,
the typ of edema is not going to be
as profound
as what you find with Nephritic. Next.
01:18
Along with hypertension
and mild edema, periorbital puffiness.
01:24
The fact that you are producing
very little urine oligo
Last time we looked at the term prefix
oligo was
when we're dealing with highdromnius,
little amniotic fluid.
01:36
This is little urine production.
01:39
Oliguria, we have approximately
and you must know the definition
of approximately 400 milliliters
of urine being produced per day. Day.
01:48
You pay attention to units due
to once again
decreased GFR from a inflamed glomeruli.
01:57
Hence the neutrophils coming in.
01:59
Here's your second h the hematuria.
02:02
Now with the hematuria,
what does that mean?
What type of RBC have we discussed earlier
that would then lead you to think
that the damage you actually took place
at the glomerulis.
02:11
And that in fact
would be a dysmorphic RBC?
What does that mean as an RBC passes
through the glomerulis?
There's every possibility
that there might be a part of that
by concave RBC,
which might not be a out pouching
at the dysmorphic RBC.
02:29
Irregular membrane
due to inflamed glamor
lie from immune complex deposition.
02:37
Let me give you a prototype
for the nephritic syndrome
and actually let me give you two of them.
02:41
One was called IGA Nephropathy, a.k.a.
02:44
a berger, and the other one will be posted
to post streptococcal glomerulonephritis.
02:49
And as the RBC is trying to make it
through, it might then become dysmorphic.
02:54
Now your laboratory findings are relevant
for nephritic. Include the fact
that you would find neutrophils
in the sediment,
particularly in the immune complex type.
03:03
So that's more involved
with inflammatory processes.
03:08
The RBC casts are key findings now.
03:10
Let me walk you through this real quick.
03:11
With nephritic, number one H hypertension
under hematuria We have RBC casts
and we have dysmorphic RBCs, this
is how that fits in perfectly.
03:24
You just need to make sure
that you organize your patterns
and thoughts accordingly.
03:29
The proteinuria will be less than three
and a half grams per day.
03:34
That's important that you pay
attention to.
03:35
Yes, greater than 150 milligrams,
but in Duffy,
less than three and a half grams per day.
03:42
Because anything beyond is what category
does that put you in very good.
03:47
Nephritic
Under Nephritic, you BUN ratio.
03:52
Well, tubular function is intact.
03:54
An acute acute glimmering nephritis.
03:57
And that's very important
for you to understand. Why?
Give me a condition in which
your tubules are also damaged.
04:06
Good.
04:07
It's called acute
tubular necrosis, isn't it?
So when you have acute tubular necrosis,
the physiology behind
that is the fact that you cannot reabsorb
any, any urea.
04:21
Where is urea in this ratio B blood,
U urea, N nitrogen. Ahh there is urea.
04:29
So an acute tuber necrosis,
you can expect that ratio to be decreased.
04:33
However, in acute glomerulonephritis,
you can still expect your asitimea
to be relatively elevated.
04:40
Isn't that interesting?